ABSTRACT
Rehabilitation and exercise are occasionally restricted by intractable pain to an extent greater than that estimated due to physical dysfunction. Here, we report three patients with intractable pain in whom Kampo medicine was highly effective, in cases where common treatments such as the administration of non-steroidal anti-inflammatory drugs and nerve blockade proved ineffective. Sokeikakketsuto extract was prescribed for three patients with different conditions: intermittent claudication of cauda equina due to lumbar spondylolisthesis, posttraumatic chronic psychogenic pain, and complex regional pain syndrome type 1 that occurred after cerebral infarction. Sokeikakketsuto extract alleviated severe pain and therefore facilitated rehabilitation and exercise in all three of these cases. From the viewpoint of Kampo medicine, we hypothesized that all three cases shared some common etiology of blood abnormalities, although conventional medical diagnosis differed for each. We suggest that treatment with Sokeikakketsuto extract corrected the blood abnormalities, thereby resulting in the successful treatment of intractable pain in these patients.
ABSTRACT
Effects of anti-oketsu drug, Keishibukuryogan (Gui-zhi-fu-ling-wan) and Tokishakuyakusan (Dang-gui-shao-yao-san) in vivo and in vitro on platelet aggregation were investigated in normal volunteers.<br>Of 20 volunteers who were given Keishibukuryogan, there were 6, 3 and 11 subjects whose dose-response curves of collagen-induced aggregations were shifted to the right, to the left, or who had no shift, respectively. The control aggregations of these 20 people were in the same range. In ADP-induced aggregation, there were 5 curves shifted to the right. Their potencies in the control aggregation were higher than those of 9 subjects who were not affected by the drug. There were 6 curves shifted to the left, and their potencies were lower than those of the 9 unaffected subjects. Of 12 volunteers who were given Tokishakuyakusan, there were 2, 2 and 8 subjects whose dose-response curves in collagen-induced aggregation were shifted to the right, the left, or who had no shift respectively. With ADP-induced aggregation, there were 1, 1 and 10 subjects whose doseresponse curves were shifted likewise. In vitro, Keishibukuryogan caused inhibition of ADP-induced aggregation but not that of collagen-induced aggregation.
ABSTRACT
The authors examined the ralationship between ‘Oketsu’ syndrome and multiple cerebral infarction. In the 59 patients (62.8±9.5 years of age; 43 male and 16 female) with multiple cerebral infarction who had undergone MRI examinations, the authors evaluated the ‘Oketsu’ score, DEA (maximum diameter of the column of intravasclar erythrocyte aggregation) and erythrocyte aggregability.<br>The control group, 18 subjects (61.2±9.3 years of age; 11 male and 7 female) had no findings of cerebral infaction upon MRI examination.<br>In the patient group, the ‘Oketsu’ score was higher than the control group (P<0.0001) and microcirculation was significantly impaired (P<0.01).<br>According to localization of foci in the MRI study, the microcircuation was particularly impaired when infarctions occurred in areas controlled by the cortical branches (P<0.05).<br>Both symptomatic and asymptomatic infarctions presented high ‘Oketsu’ scores and impairment of microcirculation.<br>Erythrocyte aggregability significantly increased in patients in the multiple infarction symptomatic group (P<0.05). Particulaly, patients suffering from cerebral infarctions in the cortical branches had more severe erythrocyte aggregation.